First Curve Today

[Jess and Marky Mark]

We are doing our first curve today and I feel like I have no idea what I'm doing.

When Mark was diagnosed on 08JUL17, his bg was 414 by blood test at the vet. The vet prescribed 2u of Lantus 2x per day (started insulin on 12JUL17; removed all dry food, and started feeding low carb/high protein wet food just before giving insulin). When he was tested at the vet on 21Jul17, his bg was 235 (he was visibly very stressed so I expected a higher number).

Here are his results so far today.
0722: 163 before food and insulin
0740: 1/2 can Instinct Rabbit
0955: 149 (it's taking us quite a few tries to figure out
1225: 77 (immediately fed 1 Tbsp dry food and 1 Tbsp wet as he was acting like he was starving)

I'm concerned that his bg may be too low for 2u twice a day.

 

[Chris & China (GA)]

Hi and Welcome to the FDMB!! This is the best place you never wanted to be!!

Your vet started you out at a higher dose than we usually recommend unless he's a very large cat.....Most cats are started at .5 to 1U twice a day and then we strongly suggest home testing every cycle to see how they're doing since their insulin needs can change often.

77 on the AlphaTrak meter is getting pretty low, but still not "dangerous"....our "time to act" on the AT is when they drop below 68 (but I totally understand that 77 seems too low right now to you!!)

What we usually do is keep some high carb canned foods like Fancy Feast Gravy Lovers around so if they drop too low, we can bring them back up safely without feeding dry (which takes too long to break down and get into the bloodstream). What I do is pop the top, put it back and "squeeze" the gravy into another bowl. Start with a teaspoon or two of just the gravy and test again in 20-30 minutes to make sure he's coming up.

You only have today's curve to go on, but I'd say it looks like he's responded very well to the diet change to low carb canned and he may be getting too much insulin. You'll still want to give twice a day, but it might be a good idea to reduce the dose a little and start testing more often to see how low he's going. Lantus dosing is based on how LOW it takes them, not the Pre-shot numbers

We have a spreadsheet we use here to keep track of test results. Here are the Instructions on getting the FDMB spreadsheet

 

[Jess and Marky Mark]

Hi and Welcome to the FDMB!! This is the best place you never wanted to be!!

Your vet started you out at a higher dose than we usually recommend unless he's a very large cat.....Most cats are started at .5 to 1U twice a day and then we strongly suggest home testing every cycle to see how they're doing since their insulin needs can change often.

77 on the AlphaTrak meter is getting pretty low, but still not "dangerous"....our "time to act" on the AT is when they drop below 68 (but I totally understand that 77 seems too low right now to you!!)

What we usually do is keep some high carb canned foods like Fancy Feast Gravy Lovers around so if they drop too low, we can bring them back up safely without feeding dry (which takes too long to break down and get into the bloodstream). What I do is pop the top, put it back and "squeeze" the gravy into another bowl. Start with a teaspoon or two of just the gravy and test again in 20-30 minutes to make sure he's coming up.

You only have today's curve to go on, but I'd say it looks like he's responded very well to the diet change to low carb canned and he may be getting too much insulin. You'll still want to give twice a day, but it might be a good idea to reduce the dose a little and start testing more often to see how low he's going. Lantus dosing is based on how LOW it takes them, not the Pre-shot numbers

We have a spreadsheet we use here to keep track of test results. Here are the Instructions on getting the FDMB spreadsheet

Thanks so much for the reply. We are very overwhelmed at this point and want to do what's best for the big dude. I'll update my signature to show his weight. Mark is currently at 14.4lbs, down from 16.9 at his annual last November.

I plan on checking in with his vet tomorrow to give her the results of the curve and see what she suggests for a dose change. She's awesome and listens well to my questions and concerns. We have some good 'gravy' food on hand I can give him if needed.

 

[Chris & China (GA)]

Mark is currently at 14.4lbs, down from 16.9 at his annual last November.

OK...at 14.4lbs, his starting dose should have been 1.5U

I plan on checking in with his vet tomorrow to give her the results of the curve and see what she suggests for a dose change. She's awesome and listens well to my questions and concerns.

I hope she really is willing to listen and understands how to treat diabetics. The sad facts are that vets only get 5 hours of formal education on diabetes when they're in school (and that covers both dogs and cats) so unless they have a special interest in feline diabetes, they tend to treat their cat patients like small dogs. They also just plain don't have the time to stay up to date on the latest treatment protocols for every disease in every type of animal they see.....they'd never have time to actually see patients if they tried!!

I'd start testing every cycle before shooting (Pre-shot tests....AMPS and PMPS) ...you wouldn't give a small child insulin without testing first to make sure they were high enough to have insulin at all, and it's the same with our furkids!!

Then (if possible) get a test somewhere mid-cycle on the AM cycle (like 5-7 hours after the shot) .....and on the PM cycle, it's really important to get a "before bed" test. Most cats drop lower at night, so we want to make sure he's safe while you sleep!

 

[Jess and Marky Mark]

Thanks again.

I won't be able to get a mid-morning reading but can definitely do a test before bed.

I think the vet will be receptive when I ask about lowering his dose. When we got the diagnosis, I told her I like/need to research so I'm armed with good info then asked her opinion on websites because I wasn't about to start Googling on my own. She recommended CatInfo.org and Binky's Page. She was receptive to me using Lisa's food chart to determine what is safe for both our special needs kitties. Another good thing is she's an advocate for home testing. She likes her patients to be in charge of their own health and gives us the tools necessary. She is quick to admit if she isn't an expert in something. I'm going to let her know about this forum, as well.

 

[Jess and Marky Mark]

We just completed the 12 hour curve. His final number was 120. He's eating now and should be getting insulin in a little bit and will be tested again before we go to bed tonight.

I will be setting up a spreadsheet when I have a chance to get on an actual computer.

 

[JanetNJ]

We are doing our first curve today and I feel like I have no idea what I'm doing.

When Mark was diagnosed on 08JUL17, his bg was 414 by blood test at the vet. The vet prescribed 2u of Lantus 2x per day (started insulin on 12JUL17; removed all dry food, and started feeding low carb/high protein wet food just before giving insulin). When he was tested at the vet on 21Jul17, his bg was 235 (he was visibly very stressed so I expected a higher number).

Here are his results so far today.
0722: 163 before food and insulin
0740: 1/2 can Instinct Rabbit
0955: 149 (it's taking us quite a few tries to figure out
1225: 77 (immediately fed 1 Tbsp dry food and 1 Tbsp wet as he was acting like he was starving)

I'm concerned that his bg may be too low for 2u twice a day.

if it was my cat I would do 1.5 u. Good job testing!

 

[Jess and Marky Mark]

I was in error earlier about his final number before his 2nd shot of Lantus. He was at 120 at 7:12pm (12 hours after receiving his first dose of the day). We gave him 1.5U then he ate about a half a can of food. He was hungry but not ravenous. His last bg of the night was 90 at 11:35pm.

Thanks for the advice during our first curve!